医疗保险制度对急性心肌梗死患者住院费用的影响。

Effects of medical insurance system on the hospitalization cost of acute myocardial infarction patients.

作者信息

Chu Ying-Hong, Jiang Gui-Hua, Zhang Hong, Luan Xiao-Rong

机构信息

Key Laboratory of Cardiovascular Proteomics of Shandong Province, Department of Geriatric Medicine, Qilu Hospital of Shandong University, Ji'nan, 250012, People's Republic of China.

Key Laboratory of Cardiovascular Remodeling and Function Research Chinese Ministry of Education and Chinese Ministry of Public Health, Department of Cardiology, Qilu Hospital of Shandong University, Ji'nan, 250012, People's Republic of China.

出版信息

Cost Eff Resour Alloc. 2022 Feb 22;20(1):8. doi: 10.1186/s12962-022-00343-6.

DOI:10.1186/s12962-022-00343-6

PMID:35193603

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8862383/

Abstract

BACKGROUND

Acute myocardial infarction is still a burden on Chinese patients. Whether different medical insurance system have any influence on the hospitalization cost and therapeutic effect of acute myocardial infarction patient needs further investigation.

METHOD

In this study, 600 patients were stratified by health insurance status to investigate the cost effectiveness.

RESULT

Compared with free medical care, patients with other health insurance status have a significantly lower age (P ˂ 0.05-0.001), the youngest of which is new rural cooperative medical system. The hospital expense, nursing fee, length of stay, daily hospitalization cost, daily drug cost, daily nursing cost and percent of nursing cost of different health insurance status were statistically significant. ANCOVA analyses controlling for age showed that the differences of hospital expenses, nursing fee, length of stay and daily hospitalization cost were still statistically significant. Further studies found that health insurance status was the leading factors influencing length of stay (β = - 0.305, P = 0.0000001), nursing costs (β = - 0.319, P = 0.004), daily hospitalization costs (β = 0.296, P = 0.0001) and occurrence of clinical events (β = - 0.186, OR = 0.830, 95% CI 0.694-0.993, P = 0.041).

CONCLUSIONS

The hospitalization cost, length of stay, nursing work and therapeutic effect of acute myocardial infarction patients are affected by different health insurance status and age.

摘要

背景

急性心肌梗死仍是中国患者面临的一项负担。不同医疗保险制度是否对急性心肌梗死患者的住院费用和治疗效果有影响，尚需进一步研究。

方法

在本研究中，600例患者按医保状态分层，以调查成本效益。

结果

与公费医疗相比，其他医保状态患者的年龄显著更低（P＜0.05 - 0.001），其中年龄最小的是新型农村合作医疗制度。不同医保状态的住院费用、护理费、住院时长、日均住院费用、日均药品费用、日均护理费用及护理费用占比差异均有统计学意义。控制年龄的协方差分析显示，住院费用、护理费、住院时长和日均住院费用的差异仍有统计学意义。进一步研究发现，医保状态是影响住院时长（β = - 0.305，P = 0.0000001）、护理成本（β = - 0.319，P = 0.004）、日均住院费用（β = 0.296，P = 0.0001）及临床事件发生情况（β = - 0.186，OR = 0.830，95%CI 0.694 - 0.993，P = 0.041）的主要因素。